Trial Information

A Pilot Study of Intraosseous Infusion of Unrelated Cord Blood Grafts

Hematopoietic (blood forming) stem cells (HSCs) reside primarily in the bone marrow.
Traditionally, HSCs have been obtained directly from the bone marrow. Transplants using
cells obtained this way are referred to as bone marrow transplants. HSCs also circulate in
the blood. Transplants using cells obtained from the blood of children and adults are
referred to as peripheral blood stem cell transplants. The blood of fetuses is especially
rich in HSCs and these cells can be easily collected at birth from the placenta.
Transplants using these cells are called cord blood transplants. Although HSCs can be
collected from various sites, all HSC transplants, regardless of the source, are given to
recipients by intravenous infusion. The transplanted HSCs then migrate to the bone marrow.

Over the past ten years unrelated cord blood transplantation has become an accepted
alternative to bone marrow transplantation. African-Americans and other minorities, who are
underrepresented in the National Marrow Donor Program, have benefited particularly from
this. In infants and young children cord blood transplantation appears to be as effective as
bone marrow transplantation. In older children, adolescents and adults, however, cord blood
transplantation has not been as effective, primarily because most cord blood units provide
an insufficient number of cells to ensure prompt and reliable engraftment ("taking" of the
transplanted cells in the recipient's bone marrow).